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Application Information NAME OF APPLICANT (Manager of Farmer’s Market) APPLICANT’S EMAIL ADDRESS COMPANY NAME PHONE NUMBER MANAGER OR COMPANY ADDRESS CITY STATE ZIP+4 FARMER’S MARKET ADDRESS CITY STATE ZIP+4 OWNER OF THE PROPERY TO BE USED FOR THE FARMER’S MARKET PROPERY OWNER’S PHONE NUMBER NAME OF FARMER’S MARKET HOURS OF OPERATION DATES THE FARMER’S MARKET WILL BE OPERATING Regulations and Responsibilities INITIALS Please initial that you have read, understood and agree to abide by the following list of regulations and responsibilities. Only the Following Items Can Be Sold: Produce, Handcrafted Foods and Beverages, Dairy Products, Meat and Seafood, Honey and Other Products From Bees, Baked Goods, Handmade Furniture, Flowers and Plants, Handmade Arts and Clothing, Food Sold From Mobile Carts The Following Items are Expressly Prohibited From Sale: Tobacco Products, Sexually Oriented Business Items, Appliances, Electronics, and Firearms Managers Shall Provide All Required Approvals by the El Paso County Department of Public Health and Safety for Each Food Vendor Managers Shall Report Sales Tax Receipts to the Town Treasurer on a Weekly Basis Managers Shall Assure That All Sanitary Facilities are Maintained to Prevent Any Health or Environmental Issues Managers Shall Provide Contact Information and Health Dept. License Numbers, as Applicable, For Every Vendor, as Well as a Photograph of Each Vendor’s Kiosk, Cart or Other Form of Setup Managers Shall Provide a Site Map Showing Placement of All Vendors, Parking Areas, and Loading/Unloading Areas Managers Shall Ensure That Vendors Comply with All Town and County Ordinances and Relevant State Statutes Each Holder of a Farmer’s Market Permit Shall, During the Time of the Permit, Maintain Liability Insurance Coverage Motorized Vehicles May Not Be Parked, Stored, or Driven On any Unpaved Areas, Except for Gravel Surfaces and May Not Be Parked on Sidewalks or Blocking Any Access Ramps or Driveways The Playing of Musical Instruments by Individuals or Small Bands is Pursuant to General Nuisance and Noise Ordinances Animals Must Be Kept on a Leash All Vendors Shall Ensure Their Site is Safe for Customer Traffic, Including Securing All Loose Objects in High Wind Conditions, Protecting the Public From Hazards Such as Extension Cords and Items Blocking Walk Routes on Site and Public Sidewalks, and Keeping Cooking or Heating Facilities Away from Areas Open to the Public Vendors Shall Remit Their Sales Tax to the Colorado Department of Revenue Applicant Signature I, the undersigned, hereinafter referred to as “Applicant”, affirm that I have read Chapter 5.53 of the Monument Municipal Code and agree to abide by all the requirements for a Farmer’s Market Permit, and I certify that the information provided in this application is accurate. I understand that a Farmer’s Market Permit is revocable in the event the permit holder violates Town or County ordinances or State Statutes, or there is an emergency that substantially interferes with the market. SIGNATURE OF APPLICANT PRINTED NAME DATE Town of Monument - Farmer’s Market Permit Application 645 Beacon Lite Rd., Monument CO 80132 [PHONE REDACTED] www.townofmonument.org Attach the Following Required Supplemental Documents: Written Permission of Property Owner If Different From Applicant Colorado Retail Food Establishment License Nos for Food Vendors Contact Info., Sales Tax ID Nos and Photograph of Each Vendor El Paso County Health Dept. License Nos for Applicable Vendors Site Map Showing Placement of Vendors, Parking, & Loading Areas Proof of Liability Insurance FOR TOWN USE ONLY: Date Application Received: Fees received: CHECK ___CREDIT CARD CASH Town of Monument BUSINESS LICENSE No. DATE APPROVED: ---PAGE BREAK--- Provide the Following Information for EACH Vendor. (Attached Extra Sheets as Needed) Vendor Name as Listed When Reporting Taxes: List Item(s) Being Sold: Contact Person: Phone: Email: Tax ID Number: Provide License Numbers Below if Applicable and Attach a Copy of the License Colorado Retail Food Establishment License No.: El Paso County Heath Dept. License No.: Vendor Name as Listed When Reporting Taxes: List Item(s) Being Sold: Contact Person: Phone: Email: Tax ID Number: Provide License Numbers Below if Applicable and Attach a Copy of the License Colorado Retail Food Establishment License No.: El Paso County Heath Dept. License No.: Vendor Name as Listed When Reporting Taxes: List Item(s) Being Sold: Contact Person: Phone: Email: Tax ID Number: Provide License Numbers Below if Applicable and Attach a Copy of the License Colorado Retail Food Establishment License No.: El Paso County Heath Dept. License No.: Vendor Name as Listed When Reporting Taxes: List Item(s) Being Sold: Contact Person: Phone: Email: Tax ID Number: Provide License Numbers Below if Applicable and Attach a Copy of the License Colorado Retail Food Establishment License No.: El Paso County Heath Dept. License No.: Vendor Name as Listed When Reporting Taxes: List Item(s) Being Sold: Contact Person: Phone: Email: Tax ID Number: Provide License Numbers Below if Applicable and Attach a Copy of the License Colorado Retail Food Establishment License No.: El Paso County Heath Dept. License No.: Vendor Name as Listed When Reporting Taxes: List Item(s) Being Sold: Contact Person: Phone: Email: Tax ID Number: Provide License Numbers Below if Applicable and Attach a Copy of the License Colorado Retail Food Establishment License No.: El Paso County Heath Dept. License No.: